Refusal of a place in a CHSLD: the family will pay $4,836 rather than $27,000

2023-04-27 08:02:07

The CIUSSS de l’Estrie — Center hospitalier universitaire de Sherbrooke (CHUS) is backtracking: it is lowering the hospital accommodation costs of more than $27,000 billed to the 90-year-old man who had refused that his wife no longer requiring acute care be transferred to a transitional accommodation more than 40 km from his home. The health establishment now requires $4,836, an amount equivalent to that paid by a user in a CHSLD.

« It’s a relief for my father, who went through a period of great stress and anxiety,” said the couple’s only son, Pierre Laliberté, adding that he had already paid the bill.

Mr. Laliberté regrets that it took an outing in the media for the fees to be reduced. ” Without [cela]there would have been no listening to the public administration, even following explaining the situation to the Service Quality and Complaints Commissioner [du CIUSSS] and the Québec Ombudsman, who rejected my file. Who are these bodies defending? And do they listen? »

Pierre Laliberté’s mother, Madeleine Pellerin, suffers from Alzheimer’s disease. She was hospitalized at the Hôtel-Dieu de Sherbrooke on May 4 due to a deterioration in her general condition. She lived until then with her husband in a house in Sherbrooke. At the end of her hospitalization, it was agreed that she might not return to her home.

In the months that followed, the CIUSSS de l’Estrie-CHUS offered him transitional accommodation, in Richmond, then in Coaticook. The family refused the two places, arguing that they were too far from the family residence. Madeleine Pellerin’s husband, her caregiver, might not have visited her regularly.

Faced with these refusals, the CIUSSS de l’Estrie imposed on the family hospital accommodation costs of $282 per day, in accordance with a regulation under the Act respecting health services and social services. Total bill: over $27,000.

The story made Quebec react. Three weeks ago, the office of the Minister for Health and Seniors, Sonia Bélanger, said it wanted to reduce the hospital accommodation costs billed to patients who refuse a place in transitional accommodation. The daily amount is currently set at $429 per day.

Contacted by The duty, the firm indicates that “regulatory modification work is in progress, in order to reduce the daily amount”. “In the coming weeks, a new directive will be sent to the establishments, we write. In the meantime, we invite establishments to show flexibility and common sense in order to avoid significant billings. »

The cabinet recalls that health establishments need hospital beds “to treat patients who present to the hospital” and “to avoid delays for interventions such as surgeries”. He points out that CHSLDs are the places “best suited to the needs” of users who no longer require acute care and cannot return to their homes. According to Quebec, “the vast majority of people accept the place available in a CHSLD or in a transitional environment”.

The CIUSSS de l’Estrie did not want to comment further on Madeleine Pellerin’s file.

CISSSs do not charge

Like the CIUSSS de l’Estrie, not all health establishments charge hospital accommodation fees. The duty made access to information requests to 22 CIUSSSs and CISSSs to find out how many invoices had been sent to patients for these fees and how much had been collected in 2020, 2021 and 2022. So far, 17 responded.

Among them, only the CISSS de l’Outaouais claims to have billed $16,920 to a patient in 2021-2022. Eleven establishments say they have identified no invoice. This is the case of the CIUSSS du Saguenay–Lac-Saint-Jean. “If users refuse a transitional accommodation place, they continue to be billed as being awaiting accommodation and the amounts are equivalent to the amounts that will be billed when the user has integrated his accommodation environment”, indicates the establishment.

The CIUSSS du Centre-Sud-de-l’Île-de-Montréal, for its part, specifies that it has “not had any cases of refusal requiring invoicing”. Surprisingly, the CISSS de Chaudière-Appalaches indicates that the daily amount for these costs “is set at $1,430 for the 2022-2023 financial year”. However, according to the Ministry of Health and Social Services, the “right amount” is rather $429.

Five health establishments did not provide the figures requested by The duty.

With Dave Noel

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